Occupational health. Recognizing and preventing work-related disease, third edition. Levy BS, Wegman DH, eds. Boston, MA: Little Brown & Co, 1995 Jan; :455-489
Work related musculoskeletal system disorders focused on low back pain (LBP) and problems of the neck and upper extremities, the most commonly occurring musculoskeletal disorders, were reviewed. Case reports describing an automobile mechanic suffering from LBP and a spot welder who developed carpal tunnel syndrome were presented to illustrate the two disorders. A discussion of LBP and neck and upper extremity disorders considered the magnitude and cost of each condition, techniques used for diagnosis, risk factors, techniques used for managing the conditions, their prognosis, and preventing and controlling the problems. LBP is considered the most costly of the occupational health problems. More than 16 billion dollars is spent each year for treating and compensating LBP patients in the US. Occupational risk factors for LBP include jobs that involve heavy physical work, static work postures, frequent bending and lifting, pushing and pulling, repetitive work, vibration exposures, and psychosocial factors such as monotony and job dissatisfaction. It has been postulated that psychological factors may be more important than physical factors for LBP severe enough to result in filing a workers' compensation claim for LBP. Only limited data exist on the incidence of neck and upper extremity disorders. The Bureau of Labor Statistics estimated that the incidence of occupational illnesses and disorders associated with repetitive trauma was three cases per 1,000 fulltime workers (case/1,000) in 1991. There has been a steady increase in the rate since 1982, when the rate was 0.4case/1,000. Risk factors for neck and upper extremity musculoskeletal disorders include repetitive and forceful motions, mechanical stress, static or awkward postures, local vibrations, and psychosocial factors originating from personality factors interacting with the way work is organized. A summary of the various categories of work related upper extremity musculoskeletal diseases was presented.